Organization
WALMART INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
7405 DEBARR RD, ANCHORAGE, AK 99504-1980
(907) 339-9037
(907) 339-9045
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72751-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR486
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1610761
—
AK
01
—
2141094
PK
—
Enumeration date
06/20/2013
Last updated
07/09/2025
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